Faisal Zaidi, Marketing Manager at TROX

Healthcare is a highly sensitive field. Small wonder, then, that hygiene and safety must meet the most critical requirements in this sector. But how can investors, consultants, architects and contractors ensure that this goal is met? In today’s healthcare environment, it has become so much about cost and how we can ‘value engineer’ a solution, which often goes with cutting down on quality and compromising the system and its service. However, at the end of the day, an HVAC solution in a healthcare environment is only successful if the highest hygiene and safety factors are met, and the person sitting in the space feels comfortable. In the sensitive field of healthcare engineering, therefore, the right HVAC solutions, and the various aspects which come within their scope, is key to good Indoor Environnmental Quality.

Controlling contamination

Air conditioning systems in hospitals must ensure that the contamination of air with microorganisms is reduced to a minimum, and that tight limits are not exceeded. Moreover, dust, anesthetic gases and odorous substances must be contained. This applies, in particular, to operating theatres, intensive care units, and maternity wards, including delivery rooms and neonatal units.

For reasons of hygiene, only a onedirectional airflow should be allowed in specific rooms, that is, from sterile areas with a minimum germ count to less sterile areas where the requirements are not quite as demanding.

A to-do list

An effective and efficient ventilation and air conditioning system not only provides a hygienic and safe environment but also improves Indoor Air Quality, which helps patients recover more quickly and the staff to perform better. Indeed, these are two aspects that finally pay off. Following are a few of the boxes that need to be checked when it comes to ventilation, air conditioning and smoke extraction technology:

• Minimise the level of microorganisms in the air, particularly in protection zones (example, operating table, instrument trolley, lab)

• Ensure the necessary air change and maintain stringent room air conditions (differential pressure, temperature and humidity)

• Limit the concentration of various substances in the occupied zone

• Prevent the spread of fire by means of fire dampers

• Prevent the spread of smoke by means of a powered smoke exhaust system

Hygienic practice in aseptic areas

The most critical requirements apply to indoor air in operating theatres. To prevent infections caused by airborne pathogens, and to ensure that standards of occupational medicine are adhered to, special attention needs to be paid to airflow and air filtration, as they play a vital role in maintaining good IEQ.

In operating theatres as well as in preop and post-op units, ventilation and air conditioning systems are indispensable. Therefore, near turbulence-free laminar flow needs to be in place to provide a dynamic shield for the special protection zone comprising the operating table and the instrument trolley. Also, filtered and conditioned extremely clean air has to be ensured to reduce the number of microorganisms to lower the risk of wound contamination. Operating theatres should only be accessed via airlocks. They have to be characterised by positive pressure so that no pathogens from neighboring rooms can enter them.

Sterile rooms

Air conditioning for areas, such as intensive care units, sterile care rooms and isolating rooms must fulfil special requirements, where the ‘outside world’ needs to be kept outside by means of different pressure levels (positive or negative pressure), airlocks and effective filtration of the supply and extract air.

Filters play a major role in sterile rooms, as they have to achieve very high efficiency levels at minimum differential pressures.

Areas adjoined the operating theatre

The DIN 1946-4-12-2008 standard contains exemplified definitions of the classes of rooms adjoined operating theatres. The latest version of this standard follows scientific research findings, which state that airborne microorganisms, in reality, pose a rather small risk of infection. As a consequence, the conditions for special protection are maintained only in areas where this is essential. Rooms adjoining operating theatres need not be protected to the same degree as operating theatres themselves. This reduces both the complexity of ventilation and air conditioning systems and the energy consumed in the adjoining areas.

In-patient wards

A sufficient supply of hygienically safe air is the prerequisite for rapid recovery of patients. It is not surprising, then, that hospitals these days prefer perfectly functioning ventilation and air conditioning systems, since they ensure patient comfort. Innovative air terminal devices with adjustable air distribution elements respond fast and reduce the air velocity, since lower velocity means reduced turbulence and, hence, increased comfort for patients.

In many countries, for example, Spain and the UK, air-water systems, such as active chilled beams are also used. Needless to say that they must meet high hygiene requirements, provide efficient filtration and allow for easy cleaning.

The visitors’ area

Hospitals have long known that it is not only the opinion of patients that count but also the impression carried by visitors. Therefore, in hospital buildings, effective and efficient ventilation and air conditioning in the visitors’ area is no less important.

Staff area

Common rooms, meeting rooms or offices are not required to have a mechanical ventilation system. However, scientists highlight the efficacy of good indoor air on the hospital staff. Studies have, in fact, shown that staff performance levels may increase by up to six per cent if they enjoy good IAQ. In other words, investing in the refurbishment of existing ventilation and air conditioning systems pays off because the economic effect of a favourable indoor air climate is an undisputed fact. Renowned scientists* have calculated that the economic benefit is up to USD 700 per year per employee. This sum can be considered as cost saving due to better staff performance and fewer staff reporting sick.

Whether it is the patients, visitors or the staff in a hospital, it is important to remember that the human being is the yardstick, and their wellbeing is our goal.

* Source: William Fisk, Olli Seppänen: Providing Better Indoor Environmental Quality Brings Economic Benefits

The writer is Marketing Manager, TROX Middle East. He can be contacted at: f.zaidi@trox.ae

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